‘My Eyes Were So Puffy I Was Unable to Even Unseal Them’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the typical reasons associated with a house full of clamorous preteen children, but since it’s the first time she will showcase her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals electing to have a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the dermis down with it.”

You risk operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are driving a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived solo in the country, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|